Form 10a - Form Of Addendum To Registration Statement To Be Filed By Professional Solicitors Page 4

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Form 10A
13.
Massachusetts General Laws, chapter 68, section 23, requires that the following disclosures be made
to each potential contributor at the time of solicitation:
The name and address of the charitable organization for whom the solicitation is being conducted
A description of how the contributions raised will be used for charitable purposes
The information that the solicitation is being conducted by a paid fundraiser
If the solicitation is for advertising the geographic distribution and circulation of any publication
in which the advertising will appear
Please attach a copy of the solicitation script for this campaign and indicate the types of monitoring
that will take place during the solicitation campaign to ensure that the required disclosures are made
and that misrepresentations do not occur (check as many as apply).
Script of oral presentation reviewed by:
Solicitor
Charity
Direct mailing reviewed by:
Solicitor
Charity
Other written presentation (e.g. pamphlets, labels, etc.) reviewed by:
Solicitor
Charity
In-room supervision of telephone solicitation by:
Solicitor
Charity
Telephone monitoring by:
Solicitor
Charity
Random follow-ups with donors by:
Solicitor
Charity
Other (explain method):
Solicitor
Charity
14.
Type of solicitation (check as many as apply):
Door-to-door
Sale or offer of goods**
Telemarketing
Sale of advertising**
Direct mail (attach letter)
Entertainment event (sale of tickets)**
Other (please explain)
Internet fundraising
**If the solicitation described in above involves the sale of goods, advertising, or tickets to an
entertainment event, complete the sales schedule on the page 5.
If the solicitation described above does not involve the sale of goods, advertising, or tickets, do not
complete the sales schedule on page five. Be sure, however, to obtain and submit the appropriate
signatures on Page 6.
Form 10A
Page 4 of 6
Rev. 07/2007

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